{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T14:01:55Z","timestamp":1785765715036,"version":"3.56.0"},"reference-count":248,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Postdoctoral Research Fellowship","award":["ICETA 2026-01"],"award-info":[{"award-number":["ICETA 2026-01"]}]},{"DOI":"10.13039\/501100001871","name":"Associate Laboratory for Green Chemistry, Clean Technologies and Processes","doi-asserted-by":"publisher","award":["UID\/50006\/2025"],"award-info":[{"award-number":["UID\/50006\/2025"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Portuguese Science and Technology Foundation","doi-asserted-by":"publisher","award":["UIDB\/CVT\/00772\/2020"],"award-info":[{"award-number":["UIDB\/CVT\/00772\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Portuguese Science and Technology Foundation","doi-asserted-by":"publisher","award":["LA\/P\/0059\/2020"],"award-info":[{"award-number":["LA\/P\/0059\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Species of the genus Streptococcus constitute important pathogens in human and veterinary medicine, being responsible for a wide spectrum of infections ranging from mild illnesses to severe invasive pathologies. Although \u03b2-lactams continue to be effective against most species, the global increase in resistance to macrolides, lincosamides, tetracyclines, and, in some cases, reduced susceptibility to penicillin represents a growing challenge for antimicrobial therapy. This review synthesizes the clinical and epidemiological landscape of antimicrobial resistance in the main Streptococcus species, including Streptococcus pyogenes, Streptococcus agalactiae, Streptococcus pneumoniae, Streptococcus dysgalactiae, and other species of clinical and veterinary relevance, addressing their epidemiological profiles, molecular mechanisms of resistance, and virulence factors. The main genetic determinants involved in resistance are discussed, namely the erm, mef, and tet genes, as well as the impact of alterations in penicillin-binding proteins, horizontal gene transfer, and biofilm formation on the persistence of infections and decreased therapeutic efficacy. Simultaneously, the main virulence factors are analyzed, including polysaccharide capsules, adhesins, toxins, extracellular enzymes, and immune response evasion mechanisms that contribute to the colonization, dissemination, and severity of infections. The importance of epidemiological and genomic surveillance, particularly through whole-genome sequencing, in monitoring the spread of resistant clones and identifying determinants of resistance and virulence is also highlighted. Taken together, the data highlight the need to strengthen programs for the rational use of antimicrobials, to promote integrated surveillance strategies from a One Health perspective, and to deepen knowledge about the interaction between antimicrobial resistance and virulence, in order to improve strategies for the prevention, diagnosis, and treatment of infections caused by Streptococcus spp.<\/jats:p>","DOI":"10.3390\/antibiotics15080751","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T12:57:56Z","timestamp":1785761876000},"page":"751","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and Epidemiological Landscape of Antimicrobial Resistance and Virulence in Streptococcus Species"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2326-6226","authenticated-orcid":false,"given":"Telma","family":"de Sousa","sequence":"first","affiliation":[{"name":"MicroART-Antibiotic Resistance Team, Department of Veterinary Sciences, University of Tr\u00e1s-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal"},{"name":"Functional Genomics and Proteomics Unit, University of Tr\u00e1s-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal"},{"name":"Associated Laboratory for Green Chemistry, University NOVA of Lisbon, 1099-085 Caparica, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catarina","family":"Silva","sequence":"additional","affiliation":[{"name":"MicroART-Antibiotic Resistance Team, Department of Veterinary Sciences, University of Tr\u00e1s-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1963-441X","authenticated-orcid":false,"given":"Jos\u00e9 Eduardo","family":"Pereira","sequence":"additional","affiliation":[{"name":"Department of Veterinary Sciences, University of Tr\u00e1s-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal"},{"name":"CECAV-Veterinary and Animal Research Centre, University of Tr\u00e1s-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6365-0735","authenticated-orcid":false,"given":"Gilberto","family":"Igrejas","sequence":"additional","affiliation":[{"name":"Functional Genomics and Proteomics Unit, University of Tr\u00e1s-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal"},{"name":"Associated Laboratory for Green Chemistry, University NOVA of Lisbon, 1099-085 Caparica, Portugal"},{"name":"Department of Genetics and Biotechnology, University of Tr\u00e1s-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0925-689X","authenticated-orcid":false,"given":"Patricia","family":"Poeta","sequence":"additional","affiliation":[{"name":"MicroART-Antibiotic Resistance Team, Department of Veterinary Sciences, University of Tr\u00e1s-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal"},{"name":"Department of Veterinary Sciences, University of Tr\u00e1s-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal"},{"name":"CECAV-Veterinary and Animal Research Centre, University of Tr\u00e1s-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal"},{"name":"Veterinary and Animal Research Centre, Associate Laboratory for Animal and Veterinary Science (AL4AnimalS), University of Tr\u00e1s-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Beres, S.B., and Musser, J.M. (2007). Contribution of Exogenous Genetic Elements to the Group A Streptococcus Metagenome. PLoS ONE, 2.","DOI":"10.1371\/journal.pone.0000800"},{"key":"ref_2","unstructured":"World Health Organization (WHO) (2023). WHO|Antimicrobial Resistance: Global Report on Surveillance 2022. Antimicrobial Resistance: Global Report on Surveillance 2022, World Health Organization (WHO)."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.diagmicrobio.2009.03.004","article-title":"Macrolide Resistance in Streptococcus Pyogenes: Prevalence, Resistance Determinants, and Emm Types","volume":"64","author":"Michos","year":"2009","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1128\/CMR.00058-15","article-title":"Biological and Epidemiological Features of Antibiotic-Resistant Streptococcus Pneumoniae in Pre- and Post-Conjugate Vaccine Eras: A United States Perspective","volume":"29","author":"Kim","year":"2016","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Rahman, M.T., Sobur, M.A., Islam, M.S., Ievy, S., Hossain, M.J., Zowalaty, M.E.E., Rahman, A.M.M.T., and Ashour, H.M. (2020). Zoonotic Diseases: Etiology, Impact, and Control. Microorganisms, 8.","DOI":"10.3390\/microorganisms8091405"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1001\/jama.2025.0910","article-title":"Invasive Group A Streptococcal Infections in 10 US States","volume":"333","author":"Gregory","year":"2025","journal-title":"JAMA"},{"key":"ref_7","unstructured":"(2026, May 04). Group A Strep Disease Surveillance and Trends|Group A Strep|CDC, Available online: https:\/\/www.cdc.gov\/group-a-strep\/php\/surveillance\/index.html."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.molmed.2013.10.004","article-title":"Streptococcal Superantigens: Categorization and Clinical Associations","volume":"20","author":"Commons","year":"2014","journal-title":"Trends Mol. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.mpmed.2025.11.011","article-title":"Staphylococcal and Streptococcal Infections","volume":"54","author":"Stoneham","year":"2026","journal-title":"Medicine"},{"key":"ref_10","unstructured":"Buxton, R. (2016). Blood Agar Plates and Hemolysis Protocols, American Society for Microbiology (ASM). Available online: https:\/\/asm.org\/protocols\/blood-agar-plates-and-hemolysis-protocols."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1084\/jem.57.4.571","article-title":"A Serological Differentiation of Human and Other Groups of Hemolytic Streptococci","volume":"57","author":"Lancefield","year":"1933","journal-title":"J. Exp. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/B978-0-12-822521-9.00240-9","article-title":"Streptococcus","volume":"Volume 1\u20134","author":"Hossain","year":"2024","journal-title":"Encyclopedia of Food Safety"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1038\/nrmicro2624","article-title":"Streptolysin S-like Virulence Factors: The Continuing SagA","volume":"9","author":"Molloy","year":"2011","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3857","DOI":"10.1128\/IAI.71.7.3857-3865.2003","article-title":"Combined Contributions of Streptolysin O and Streptolysin S to Virulence of Serotype M5 Streptococcus Pyogenes Strain Manfredo","volume":"71","author":"Fontaine","year":"2003","journal-title":"Infect. Immun."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1891","DOI":"10.3201\/eid1512.090232","article-title":"Towards Control of Streptococcus Iniae","volume":"15","author":"Baiano","year":"2009","journal-title":"Emerg. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Perez Pardo, C., Gonzalez, R.C., Pinto, M.E.S., and Galiana, A. (2020). Streptococcus Gallolyticus and Its Implication in Colorectal Cancer. Colorectal Neoplasia and the Colorectal Microbiome, Academic Press.","DOI":"10.1016\/B978-0-12-819672-4.00003-9"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Reglinski, M., and Sriskandan, S. (2014). Streptococcus Pyogenes. Molecular Medical Microbiology, Academic Press.","DOI":"10.1016\/B978-0-12-397169-2.00038-X"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1097\/QCO.0000000000001095","article-title":"The Reemergence of Streptococcus Pyogenes in Skin and Soft Tissue Infections: A Review of Epidemiology, Pathogenesis, and Management Strategies","volume":"38","author":"Bassetti","year":"2025","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_19","first-page":"44","article-title":"Antibiotics Used to Treat Streptococcus Pyogenes Infections","volume":"14","author":"Migdadi","year":"2026","journal-title":"J. Med. Bacteriol."},{"key":"ref_20","unstructured":"Spellerberg, B., and Brandt, C. (2022). Laboratory Diagnosis of Streptococcus Pyogenes (Group A Streptococci). Streptococcus pyogenes: Basic Biology to Clinical Manifestations, University of Oklahoma Health Sciences Center."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1086\/656735","article-title":"Quality and Strength of Evidence of the Infectious Diseases Society of America Clinical Practice Guidelines","volume":"51","author":"Khan","year":"2010","journal-title":"Clin. Infect. Dis."},{"key":"ref_22","unstructured":"Hanna, M., and Shah, M. (2025). Streptococcus Group B. StatPearls, StatPearls Publishing."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1128\/microbiolspec.GPP3-0007-2018","article-title":"Group B Streptococcus (Streptococcus Agalactiae)","volume":"7","author":"Raabe","year":"2019","journal-title":"Microbiol. Spectr."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Hsu, C.Y., Moradkasani, S., Suliman, M., Uthirapathy, S., Zwamel, A.H., Hjazi, A., Vashishth, R., and Beig, M. (2025). Global Patterns of Antibiotic Resistance in Group B Streptococcus: A Systematic Review and Meta-Analysis. Front. Microbiol., 16.","DOI":"10.3389\/fmicb.2025.1541524"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1007\/s10096-020-04041-0","article-title":"Invasive Group B Streptococcus among Non-Pregnant Adults in Brussels-Capital Region, 2005\u20132019","volume":"40","author":"Graux","year":"2020","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e13501","DOI":"10.1111\/aji.13501","article-title":"Group B Streptococcal Infection of the Genitourinary Tract in Pregnant and Non-Pregnant Patients with Diabetes Mellitus: An Immunocompromised Host or Something More?","volume":"86","author":"Nguyen","year":"2021","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_27","first-page":"429","article-title":"Streptococcus Agalactiae Mastitis: A Review","volume":"38","author":"Keefe","year":"1997","journal-title":"Can. Vet. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1111\/lam.13015","article-title":"Biofilm Formation on Different PH Conditions by Streptococcus Agalactiae Isolated from Bovine Mastitic Milk","volume":"67","author":"Miranda","year":"2018","journal-title":"Lett. Appl. Microbiol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Gerez, G., Hernandez, L.B., Cadona, J., Sanso, A.M., and Bustamante, A.V. (2025). Genetic Diversity of Streptococcus Agalactiae from Dairy Cattle with Mastitis in Argentina. BMC Vet. Res., 21.","DOI":"10.1186\/s12917-025-04584-4"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e00175-23","DOI":"10.1128\/cmr.00175-23","article-title":"Streptococcus dysgalactiae Subsp. equisimilis Infection and Its Intersection with Streptococcus pyogenes","volume":"37","author":"Xie","year":"2024","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"109524","DOI":"10.1016\/j.vetmic.2022.109524","article-title":"Streptococcus Canis, the Underdog of the Genus","volume":"273","author":"Pagnossin","year":"2022","journal-title":"Vet. Microbiol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Cito, F., Di Francesco, C.E., Averaimo, D., Chiaverini, A., Alessiani, A., Di Domenico, M., Cresci, M., Rulli, M., Cantelmi, M.C., and Di Bernardo, M.D. (2025). Streptococcus Equi Subsp. Zooepidemicus: Epidemiological and Genomic Findings of an Emerging Pathogen in Central Italy. Animals, 15.","DOI":"10.20944\/preprints202503.2108.v1"},{"key":"ref_33","first-page":"1020","article-title":"Severe Streptococcus Equi Subspecies Zooepidemicus Outbreak from Unpasteurized Dairy Product Consumption, Italy\u2014Volume 29, Number 5\u2014May 2023\u2014Emerging Infectious Diseases Journal\u2014CDC","volume":"29","author":"Bosica","year":"2023","journal-title":"Emerg. Infect. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1128\/microbiolspec.ARBA-0008-2017","article-title":"Antimicrobial Resistance in Streptococcus spp","volume":"6","author":"Haenni","year":"2018","journal-title":"Microbiol. Spectr."},{"key":"ref_35","first-page":"480","article-title":"Association between Colorectal Cancer and Streptococcus gallolyticus Subsp. pasteuranus (Former S. bovis) Endocarditis: Clinical Relevance and Cues for Microbiota Science. Case Report and Review of the Literature","volume":"25","author":"Agnes","year":"2021","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1093\/cid\/cir609","article-title":"Clinical Importance of Streptococcus Gallolyticus Infection among Colorectal Cancer Patients: Systematic Review and Meta-Analysis","volume":"53","author":"Boleij","year":"2011","journal-title":"Clin. Infect. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e9","DOI":"10.1017\/gmb.2024.11","article-title":"Factors Underlying the Association between Streptococcus Gallolyticus, Subspecies Gallolyticus Infection and Colorectal Cancer: A Mini Review","volume":"5","author":"Warner","year":"2024","journal-title":"Gut Microbiome"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.syapm.2010.11.010","article-title":"Differentiation of Species of the Streptococcus Bovis\/Equinus-Complex by MALDI-TOF Mass Spectrometry in Comparison to SodA Sequence Analyses","volume":"34","author":"Hinse","year":"2011","journal-title":"Syst. Appl. Microbiol."},{"key":"ref_39","first-page":"160","article-title":"A Case of Streptococcus gallolyticus Subsp. gallolyticus Infective Endocarditis with Colon Cancer: Identification by 16S Ribosomal DNA Sequencing","volume":"30","author":"Kim","year":"2010","journal-title":"Korean J. Lab. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.3201\/eid2007.131594","article-title":"Epidemiology, Clinical Manifestations, and Outcomes of Streptococcus Suis Infection in Humans","volume":"20","author":"Huong","year":"2014","journal-title":"Emerg. Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"683","DOI":"10.26444\/aaem\/79813","article-title":"Streptococcus Suis: A Re-Emerging Pathogen Associated with Occupational Exposure to Pigs or Pork Products. Part I\u2014Epidemiology","volume":"24","author":"Dutkiewicz","year":"2017","journal-title":"Ann. Agric. Environ. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e32414","DOI":"10.1097\/MD.0000000000032414","article-title":"Case Report: One Human Streptococcus Suis Occurred in Shandong Province, China","volume":"101","author":"Chen","year":"2022","journal-title":"Medicine"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"van Samkar, A., Brouwer, M.C., Schultsz, C., van der Ende, A., and van de Beek, D. (2015). Streptococcus Suis Meningitis: A Systematic Review and Meta-Analysis. PLoS Negl. Trop. Dis., 9.","DOI":"10.1371\/journal.pntd.0004191"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/bs.ampbs.2020.12.002","article-title":"Streptococcus Suis Pathogenesis\u2014A Diverse Array of Virulence Factors for a Zoonotic Lifestyle","volume":"78","author":"Tram","year":"2021","journal-title":"Adv. Microb. Physiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"101098","DOI":"10.1016\/j.onehlt.2025.101098","article-title":"Streptococcus Suis: Epidemiology and Resistance Evolution of an Emerging Zoonotic Bacteria","volume":"21","author":"Liu","year":"2025","journal-title":"One Health"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"P\u00e9rez-Sancho, M., Vela, A.I., Garc\u00eda-Seco, T., Gottschalk, M., Dom\u00ednguez, L., and Fern\u00e1ndez-Garayz\u00e1bal, J.F. (2015). Assessment of MALDI-TOF MS as Alternative Tool for Streptococcus Suis Identification. Front. Public Health, 3.","DOI":"10.3389\/fpubh.2015.00202"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1086\/596763","article-title":"Streptococcus Suis: An Emerging Human Pathogen","volume":"48","author":"Wertheim","year":"2009","journal-title":"Clin. Infect. Dis."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Panpaeng, C., Kamolvit, W., Karaketklang, K., and Jitmuang, A. (2025). Clinical Characteristics and Trends in the Antimicrobial Susceptibility Profile of Streptococcus Suis Infections in a Large Tertiary Hospital, Thailand, 2007\u20132023. PLoS Negl. Trop. Dis., 19.","DOI":"10.1371\/journal.pntd.0013110"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/S1473-3099(24)00456-0","article-title":"The Evidence Base for the Optimal Antibiotic Treatment Duration of Upper and Lower Respiratory Tract Infections: An Umbrella Review","volume":"25","author":"Kuijpers","year":"2025","journal-title":"Lancet Infect. Dis."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"80","DOI":"10.18773\/austprescr.2024.024","article-title":"Controversies in the Management of Community-Acquired Pneumonia in Adults","volume":"47","author":"Tucker","year":"2024","journal-title":"Aust. Prescr."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1097\/MCP.0000000000001153","article-title":"Community Acquired Pneumonia Due to Antibiotic Resistant- Streptococcus Pneumoniae: Diagnosis, Management and Prevention","volume":"31","author":"Lui","year":"2025","journal-title":"Curr. Opin. Pulm. Med."},{"key":"ref_52","first-page":"511","article-title":"Streptococcus\u00a0pneumoniae","volume":"Volume 1","author":"Ahmed","year":"2025","journal-title":"Encyclopedia of Infection and Immunity"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e00778-23","DOI":"10.1128\/msphere.00778-23","article-title":"Intraspecies Interactions of Streptococcus Mutans Impact Biofilm Architecture and Virulence Determinants in Childhood Dental Caries","volume":"9","author":"Momeni","year":"2024","journal-title":"mSphere"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"E963","DOI":"10.1161\/CIR.0000000000000969","article-title":"Prevention of Viridans Group Streptococcal Infective Endocarditis: A Scientific Statement from the American Heart Association","volume":"143","author":"Wilson","year":"2021","journal-title":"Circulation"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.22207\/JPAM.16.3.26","article-title":"A Review on Updated Species List of Viridans Streptococci Causing Infective Endocarditis","volume":"16","author":"Lakshmi","year":"2022","journal-title":"J. Pure Appl. Microbiol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S0924-8579(99)00172-7","article-title":"Viridans-Group Streptococcal Infections in Immunocompromised Hosts","volume":"14","author":"Shenep","year":"2000","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1111\/j.1399-302X.1998.tb00698.x","article-title":"Current Classification of the Oral Streptococci","volume":"13","author":"Whiley","year":"1998","journal-title":"Oral Microbiol. Immunol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e01752-21","DOI":"10.1128\/Spectrum.01752-21","article-title":"Type IV Pili of Streptococcus Sanguinis Contribute to Pathogenesis in Experimental Infective Endocarditis","volume":"9","author":"Martini","year":"2021","journal-title":"Microbiol. Spectr."},{"key":"ref_59","first-page":"7127848","article-title":"Streptococcus Gordonii: A Rare Cause of Infective Endocarditis","volume":"2019","author":"Mosailova","year":"2019","journal-title":"Case Rep. Infect. Dis."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1159\/000324598","article-title":"Biology of Streptococcus Mutans-Derived Glucosyltransferases: Role in Extracellular Matrix Formation of Cariogenic Biofilms","volume":"45","author":"Bowen","year":"2011","journal-title":"Caries Res."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Pilarczyk-Zurek, M., Sitkiewicz, I., and Koziel, J. (2022). The Clinical View on Streptococcus Anginosus Group\u2014Opportunistic Pathogens Coming Out of Hiding. Front. Microbiol., 13.","DOI":"10.3389\/fmicb.2022.956677"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1128\/jcm.30.1.243-244.1992","article-title":"Streptococcus Intermedius, Streptococcus Constellatus, and Streptococcus Anginosus (the Streptococcus Milleri Group): Association with Different Body Sites and Clinical Infections","volume":"30","author":"Whiley","year":"1992","journal-title":"J. Clin. Microbiol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1186\/2047-783X-15-7-319","article-title":"Multiple Liver Abscesses with Isolation of Streptococcus Intermedius Related to a Pyogenic Dental Infection in an Immuno-Competent Patient","volume":"15","author":"Neumayr","year":"2010","journal-title":"Eur. J. Med. Res."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Abd El-Aziz, N.K., Ammar, A.M., El Damaty, H.M., Abd Elkader, R.A., Saad, H.A., El-Kazzaz, W., and Khalifa, E. (2021). Environmental Streptococcus Uberis Associated with Clinical Mastitis in Dairy Cows: Virulence Traits, Antimicrobial and Biocide Resistance, and Epidemiological Typing. Animals, 11.","DOI":"10.3390\/ani11071849"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"16059","DOI":"10.1038\/nrdp.2016.59","article-title":"Infective Endocarditis","volume":"2","author":"Holland","year":"2016","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Sayan, O.R., and Carter, W.A. (2012). Endocarditis. Emergency Medicine: Clinical Essentials, Elsevier. [2nd ed.].","DOI":"10.1016\/B978-1-4377-3548-2.00062-8"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e99","DOI":"10.1016\/j.jinf.2006.05.010","article-title":"Successful Ceftriaxone Therapy of Endocarditis Due to Penicillin Non-Susceptible Viridans Streptococci","volume":"54","author":"Shelburne","year":"2007","journal-title":"J. Infect."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1093\/jac\/dkl087","article-title":"Antimicrobial Treatment of Infective Endocarditis Caused by Viridans Streptococci Highly Susceptible to Penicillin: Historic Overview and Future Considerations","volume":"57","author":"Verhagen","year":"2006","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_69","unstructured":"European Centre for Disease Prevention and Control, and WHO (2023). Antimicrobial Resistance Surveillance in Europe 2023\u20132021 Data, WHO."},{"key":"ref_70","unstructured":"European Medicines Agency (2025). European Sales and Use of Antimicrobials for Veterinary Medicine: Annual Surveillance Report for 2024, Publications Office of the European Union."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"e01993-19","DOI":"10.1128\/JCM.01993-19","article-title":"Reduced In Vitro Susceptibility of Streptococcus Pyogenes to \u03b2-Lactam Antibiotics Associated with Mutations in the Pbp2x Gene Is Geographically Widespread","volume":"58","author":"Musser","year":"2020","journal-title":"J. Clin. Microbiol."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Ferreira, L.N., Alves Pimentel Hecht, B., Sanches, L., Santos, D., and Nagao, P.E. (2026). Penicillin-Binding Proteins in Streptococcus Agalactiae and Their Association with Reduced Penicillin Susceptibility: An Overview. Antibiotics, 15.","DOI":"10.3390\/antibiotics15010031"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"25","DOI":"10.24171\/j.phrp.2019.10.1.06","article-title":"Analysis of Resistance to Macrolide-Lincosamide-Streptogramin B Among MecA-Positive Staphylococcus Aureus Isolates","volume":"10","author":"Khodabandeh","year":"2019","journal-title":"Osong Public Health Res. Perspect."},{"key":"ref_74","first-page":"11","article-title":"Mechanisms of Resistance to Aminoglycoside Antibiotics: Overview and Perspectives","volume":"7","author":"Labby","year":"2015","journal-title":"Medchemcomm"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1046\/j.1365-2958.1999.01521.x","article-title":"\u03b2-Lactam Resistance in Streptococcus Pneumoniae: Penicillin-Binding Proteins and Non-Penicillin-Binding Proteins","volume":"33","author":"Hakenbeck","year":"1999","journal-title":"Mol. Microbiol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.csbj.2015.03.007","article-title":"Mechanisms and Impact of Genetic Recombination in the Evolution of Streptococcus Pneumoniae","volume":"13","author":"Chaguza","year":"2015","journal-title":"Comput. Struct. Biotechnol. J."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.ijantimicag.2005.10.003","article-title":"Evidence for Tetracycline Resistance Determinant Tet(M) Allele Replacement in a Streptococcus Pneumoniae Population of Limited Geographical Origin","volume":"27","author":"Semczuk","year":"2006","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_78","first-page":"266","article-title":"Resistance to \u03b2-Lactams in Streptococcus Pneumoniae","volume":"53","author":"Mollerach","year":"2021","journal-title":"Rev. Argent. de Microbiol.\/Argent. J. Microbiol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"4622","DOI":"10.1128\/AAC.49.11.4622-4627.2005","article-title":"Amino Acid Mutations Essential to Production of an Altered PBP 2X Conferring High-Level \u03b2-Lactam Resistance in a Clinical Isolate of Streptococcus Pneumoniae","volume":"49","author":"Smith","year":"2005","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_80","unstructured":"European Centre for Disease Prevention and Control (ECDC) (2025). Antimicrobial Resistance in the EU\/EEA (EARS-Net)\u2014Annual Epidemiological Report for 2024, ECDC."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Munita, J.M., and Arias, C.A. (2016). Mechanisms of Antibiotic Resistance. Virulence Mechanisms of Bacterial Pathogens, Wiley & Sons. [5th ed.].","DOI":"10.1128\/9781555819286.ch17"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"e03618-21","DOI":"10.1128\/mbio.03618-21","article-title":"Integrative Reverse Genetic Analysis Identifies Polymorphisms Contributing to Decreased Antimicrobial Agent Susceptibility in Streptococcus Pyogenes","volume":"13","author":"Beres","year":"2022","journal-title":"mBio"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1016\/j.ajpath.2022.06.011","article-title":"A Chimeric Penicillin Binding Protein 2X Significantly Decreases in Vitro Beta-Lactam Susceptibility and Increases in Vivo Fitness of Streptococcus Pyogenes","volume":"192","author":"Olsen","year":"2022","journal-title":"Am. J. Pathol."},{"key":"ref_84","doi-asserted-by":"crossref","unstructured":"Berbel, D., Gonz\u00e1lez-D\u00edaz, A., L\u00f3pez de Egea, G., C\u00e0mara, J., and Ardanuy, C. (2022). An Overview of Macrolide Resistance in Streptococci: Prevalence, Mobile Elements and Dynamics. Microorganisms, 10.","DOI":"10.3390\/microorganisms10122316"},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Villal\u00f3n, P., B\u00e1rcena, M., Medina-Pascual, M.J., Garrido, N., Pino-Rosa, S., Carrasco, G., and Valdezate, S. (2023). National Surveillance of Tetracycline, Erythromycin, and Clindamycin Resistance in Invasive Streptococcus Pyogenes: A Retrospective Study of the Situation in Spain, 2007\u20132020. Antibiotics, 12.","DOI":"10.3390\/antibiotics12010099"},{"key":"ref_86","first-page":"45","article-title":"Characterization of Macrolide Resistance in Streptococcus Pyogenes: Prevalence, Phenotype and Genotype","volume":"20","author":"Javan","year":"2015","journal-title":"Pajoohandeh J."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1007\/s00284-025-04334-7","article-title":"Characterization of Penicillin-Non-Susceptible, Multidrug-Resistant Streptococcus Agalactiae Using Whole-Genome Sequencing","volume":"82","author":"Park","year":"2025","journal-title":"Curr. Microbiol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"6431","DOI":"10.1073\/pnas.1504725112","article-title":"Sequence Type 1 Group B Streptococcus, an Emerging Cause of Invasive Disease in Adults, Evolves by Small Genetic Changes","volume":"112","author":"Flores","year":"2015","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"4544","DOI":"10.1038\/ncomms5544","article-title":"Streptococcus Agalactiae Clones Infecting Humans Were Selected and Fixed through the Extensive Use of Tetracycline","volume":"5","author":"Davies","year":"2014","journal-title":"Nat. Commun."},{"key":"ref_90","first-page":"183","article-title":"Macrolide-Resistance, Capsular Genotyping and Associated Factors of Group B Streptococci Colonized Pregnant Women in Isfahan, Iran","volume":"13","author":"Rostami","year":"2021","journal-title":"Iran. J. Microbiol."},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Boyanov, V.S., Alexandrova, A.S., and Gergova, R.T. (2025). Genetic Determinants and Clonal Composition of Levofloxacin-Resistant Streptococcus Agalactiae Isolates from Bulgaria. Antibiotics, 14.","DOI":"10.3390\/antibiotics14111121"},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Tzialla, C., Salom\u00e8, S., Mond\u00ec, V., Salvo, V., and Berardi, A. (2026). Antibiotic Prophylaxis and Treatment of Neonatal Group B Streptococcus Disease in the Era of Antimicrobial Resistance. Antibiotics, 15.","DOI":"10.3390\/antibiotics15030306"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"D20","DOI":"10.1016\/j.vaccine.2012.11.056","article-title":"Intrapartum Antibiotic Prophylaxis for the Prevention of Perinatal Group B Streptococcal Disease: Experience in the United States and Implications for a Potential Group B Streptococcal Vaccine","volume":"31","author":"Schrag","year":"2013","journal-title":"Vaccine"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1093\/infdis\/157.4.764","article-title":"Serious Infections Due to Penicillin-Resistant Strains of Viridans Streptococci with Altered Penicillin-Binding Proteins","volume":"157","author":"Quinn","year":"1988","journal-title":"J. Infect. Dis."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/j.ijantimicag.2004.06.003","article-title":"Characterisation of Viridans Group Streptococci with Different Levels of Tet(M)-Mediated Tetracycline Resistance","volume":"24","author":"Stapleton","year":"2004","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1093\/jac\/dki404","article-title":"Macrolide Resistance Mechanisms and in Vitro Susceptibility Patterns of Viridans Group Streptococci Isolated from Blood Cultures","volume":"57","author":"Ergin","year":"2006","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1093\/jac\/dkh479","article-title":"Viridans Streptococci in Endocarditis and Neutropenic Sepsis: Biofilm Formation and Effects of Antibiotics","volume":"55","author":"Presterl","year":"2005","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"2792","DOI":"10.1128\/AAC.42.11.2792","article-title":"Fluoroquinolone Resistance Mutations in the ParC, ParE, and GyrA Genes of Clinical Isolates of Viridans Group Streptococci","volume":"42","author":"Georgiou","year":"1998","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1093\/femsre\/fux010","article-title":"Molecular Mechanisms of Biofilm-Based Antibiotic Resistance and Tolerance in Pathogenic Bacteria","volume":"41","author":"Hall","year":"2017","journal-title":"FEMS Microbiol. Rev."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1007\/s00284-023-03337-6","article-title":"Phenotypic and Genotypic Characterization of Antimicrobial Resistance in Streptococci Isolated from Human and Animal Clinical Specimens","volume":"80","author":"Glajzner","year":"2023","journal-title":"Curr. Microbiol."},{"key":"ref_101","doi-asserted-by":"crossref","unstructured":"Glambek, M., Kjos, M., M\u00e5rli, M.T., Salehian, Z., Skrede, S., Sivertsen, A., Kittang, B.R., and Oppegaard, O. (2025). TrexAB, a Novel Tetracycline Resistance Determinant in Streptococcus Dysgalactiae. Front. Cell. Infect. Microbiol., 15.","DOI":"10.3389\/fcimb.2025.1583926"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"2500179","DOI":"10.2807\/1560-7917.ES.2025.30.45.2500179","article-title":"Higher Valency Vaccines\u2019 Impact on Antimicrobial Resistance Rates in Streptococcus Pneumoniae Causing Invasive Disease: A Retrospective Analysis Based on National Reference Laboratory Data, Belgium, 2018 to 2023","volume":"30","author":"Vermeulen","year":"2025","journal-title":"Eurosurveillance"},{"key":"ref_103","doi-asserted-by":"crossref","unstructured":"Shivaee, A., Kazemi, F., Navidifar, T., Golab, N., Parvizi, E., Mofid, M., Sholeh, M., and Beig, M. (2025). Global Trends in Macrolide and Lincosamide Resistance in Streptococcus Species: A Comprehensive Systematic Review and Meta-Analysis. BMC Infect. Dis., 25.","DOI":"10.1186\/s12879-025-11884-5"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1093\/femsre\/fux023","article-title":"Evolution of Bacterial Virulence","volume":"41","author":"Diard","year":"2017","journal-title":"FEMS Microbiol. Rev."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"1600","DOI":"10.1111\/jam.15090","article-title":"A Current Review of Pathogenicity Determinants of Streptococcus sp","volume":"131","author":"Nagao","year":"2021","journal-title":"J. Appl. Microbiol."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/978-3-319-20819-0_1","article-title":"Evolution of Immunity and Pathogens","volume":"57","author":"Jack","year":"2015","journal-title":"Results Probl. Cell Differ."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"s-5","DOI":"10.1089\/sur.2006.7.s2-5","article-title":"Host Defense Mechanisms against Pathogens","volume":"7","author":"Accolla","year":"2006","journal-title":"Surg. Infect."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"20232043","DOI":"10.1098\/rspb.2023.2043","article-title":"Darwin Review: The Evolution of Virulence in Human Pathogens","volume":"291","author":"Gupta","year":"2024","journal-title":"Proc. R. Soc. B Biol. Sci."},{"key":"ref_109","unstructured":"Cattoir, V. (2022). Mechanisms of Streptococcus Pyogenes Antibiotic Resistance. Streptococcus pyogenes: Basic Biology to Clinical Manifestation, University of Oklahoma Health Sciences Center."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1038\/s41579-018-0001-8","article-title":"Streptococcus Pneumoniae: Transmission, Colonization and Invasion","volume":"16","author":"Weiser","year":"2018","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_111","doi-asserted-by":"crossref","unstructured":"Srithanasuwan, A., Pangprasit, N., and Suriyasathaporn, W. (2022). Comparison of Virulence Patterns Between Streptococcus Uberis Causing Transient and Persistent Intramammary Infection. Front. Vet. Sci., 9.","DOI":"10.3389\/fvets.2022.806674"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"875","DOI":"10.14202\/vetworld.2016.875-881","article-title":"Molecular Characterization of Virulence Genes of Streptococcus equi subsp. equi and Streptococcus equi subsp. zooepidemicus in Equines","volume":"9","author":"Javed","year":"2016","journal-title":"Vet. World"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"260","DOI":"10.3201\/eid2902.221218","article-title":"Streptococcus Dysgalactiae Bloodstream Infections, Norway, 1999\u20132021","volume":"29","author":"Oppegaard","year":"2023","journal-title":"Emerg. Infect. Dis."},{"key":"ref_114","doi-asserted-by":"crossref","unstructured":"Segura, M., Aragon, V., Brockmeier, S.L., Gebhart, C., de Greeff, A., Kerdsin, A., O\u2019Dea, M.A., Okura, M., Sal\u00e9ry, M., and Schultsz, C. (2020). Update on Streptococcus Suis Research and Prevention in the Era of Antimicrobial Restriction: 4th International Workshop on S. Suis. Pathogens, 9.","DOI":"10.3390\/pathogens9050374"},{"key":"ref_115","doi-asserted-by":"crossref","unstructured":"Brooks, L.R.K., and Mias, G.I. (2018). Streptococcus Pneumoniae\u2019s Virulence and Host Immunity: Aging, Diagnostics, and Prevention. Front. Immunol., 9.","DOI":"10.3389\/fimmu.2018.01366"},{"key":"ref_116","doi-asserted-by":"crossref","unstructured":"Siemens, N., and L\u00fctticken, R. (2021). Streptococcus pyogenes (\u201cGroup A Streptococcus\u201d), a Highly Adapted Human Pathogen\u2014Potential Implications of Its Virulence Regulation for Epidemiology and Disease Management. Pathogens, 10.","DOI":"10.3390\/pathogens10060776"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1165\/ajrcmb\/5.5.416","article-title":"Pneumolysin Induces the Salient Histologic Features of Pneumococcal Infection in the Rat Lung in Vivo","volume":"5","author":"Feldman","year":"1991","journal-title":"Am. J. Respir. Cell Mol. Biol."},{"key":"ref_118","doi-asserted-by":"crossref","unstructured":"Maestro, B., and Sanz, J.M. (2016). Choline Binding Proteins from Streptococcus pneumoniae: A Dual Role as Enzybiotics and Targets for the Design of New Antimicrobials. Antibiotics, 5.","DOI":"10.3390\/antibiotics5020021"},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1084\/jem.47.1.9","article-title":"Contributions to the Pathology of Experimental Virus Encephalitis: IV. Recurring Strains of Herpes Virus","volume":"47","author":"Flexner","year":"1928","journal-title":"J. Exp. Med."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"2181","DOI":"10.1128\/JB.184.8.2181-2191.2002","article-title":"Differential Recognition of Surface Proteins in Streptococcus pyogenes by Two Sortase Gene Homologs","volume":"184","author":"Barnett","year":"2002","journal-title":"J. Bacteriol."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"e00637-24","DOI":"10.1128\/jcm.00637-24","article-title":"Divergent Effects of Emm Types 1 and 12 on Invasive Group A Streptococcal Infections\u2014Results of a Retrospective Cohort Study, Germany 2023","volume":"62","author":"Bertram","year":"2024","journal-title":"J. Clin. Microbiol."},{"key":"ref_122","doi-asserted-by":"crossref","unstructured":"Gherardi, G., Vitali, L.A., and Creti, R. (2018). Prevalent Emm Types among Invasive GAS in Europe and North America since Year 2000. Front. Public Health, 6.","DOI":"10.3389\/fpubh.2018.00059"},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1016\/S1473-3099(09)70178-1","article-title":"Global Emm Type Distribution of Group A Streptococci: Systematic Review and Implications for Vaccine Development","volume":"9","author":"Steer","year":"2009","journal-title":"Lancet Infect. Dis."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"5119","DOI":"10.1128\/iai.60.12.5119-5125.1992","article-title":"Expression of Protein F, the Fibronectin-Binding Protein of Streptococcus Pyogenes JRS4, in Heterologous Streptococcal and Enterococcal Strains Promotes Their Adherence to Respiratory Epithelial Cells","volume":"60","author":"Hanski","year":"1992","journal-title":"Infect. Immun."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"6172","DOI":"10.1073\/pnas.89.13.6172","article-title":"Protein F, a Fibronectin-Binding Protein, Is an Adhesin of the Group A Streptococcus Streptococcus Pyogenes","volume":"89","author":"Hanski","year":"1992","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1128\/CMR.00101-13","article-title":"Disease Manifestations and Pathogenic Mechanisms of Group A Streptococcus","volume":"27","author":"Walker","year":"2014","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"111677","DOI":"10.1016\/j.isci.2024.111677","article-title":"The Burden of Group A Streptococcus (GAS) Infections: The Challenge Continues in the Twenty-First Century","volume":"28","author":"Thacharodi","year":"2025","journal-title":"iScience"},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1159\/000353754","article-title":"Plasmin(Ogen) Acquisition by Group A Streptococcus Protects against C3b-Mediated Neutrophil Killing","volume":"6","author":"Ly","year":"2014","journal-title":"J. Innate Immun."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1111\/j.1365-2958.2005.04977.x","article-title":"Anti-Phagocytic Mechanisms of Streptococcus Pyogenes: Binding of Fibrinogen to M-Related Protein","volume":"59","author":"Courtney","year":"2006","journal-title":"Mol. Microbiol."},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1073\/pnas.85.5.1657","article-title":"Antiphagocytic Activity of Streptococcal M Protein: Selective Binding of Complement Control Protein Factor H","volume":"85","author":"Horstmann","year":"1988","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1128\/iai.64.2.503-510.1996","article-title":"C5a Peptidase Alters Clearance and Trafficking of Group A Streptococci by Infected Mice","volume":"64","author":"Yinduo","year":"1996","journal-title":"Infect. Immun."},{"key":"ref_132","doi-asserted-by":"crossref","unstructured":"Lynskey, N.N., Reglinski, M., Calay, D., Siggins, M.K., Mason, J.C., Botto, M., and Sriskandan, S. (2017). Multi-Functional Mechanisms of Immune Evasion by the Streptococcal Complement Inhibitor C5a Peptidase. PLoS Pathog., 13.","DOI":"10.1371\/journal.ppat.1006493"},{"key":"ref_133","doi-asserted-by":"crossref","unstructured":"Shumba, P., Shambat, S.M., and Siemens, N. (2019). The Role of Streptococcal and Staphylococcal Exotoxins and Proteases in Human Necrotizing Soft Tissue Infections. Toxins, 11.","DOI":"10.3390\/toxins11060332"},{"key":"ref_134","unstructured":"Barnett, T., Indraratna, A., and Sanderson-Smith, M. (2022). Secreted Virulence Factors of Streptococcus pyogenes. Streptococcus pyogenes: Basic Biology to Clinical Manifestations, University of Oklahoma Health Sciences Center."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/j.jinf.2019.02.005","article-title":"Identification of Two New Core Chromosome-Encoded Superantigens in Streptococcus pyogenes; SpeQ and SpeR","volume":"78","author":"Reglinski","year":"2019","journal-title":"J. Infect."},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"5018","DOI":"10.1038\/s41467-020-18700-5","article-title":"Prophage Exotoxins Enhance Colonization Fitness in Epidemic Scarlet Fever-Causing Streptococcus Pyogenes","volume":"11","author":"Brouwer","year":"2020","journal-title":"Nat. Commun."},{"key":"ref_137","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.1111\/cmi.12531","article-title":"Streptococcal Toxins: Role in Pathogenesis and Disease","volume":"17","author":"Barnett","year":"2015","journal-title":"Cell. Microbiol."},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"297","DOI":"10.2174\/138945012799424589","article-title":"The Role of Streptokinase as a Virulence Determinant of Streptococcus Pyogenes\u2014Potential for Therapeutic Targeting","volume":"13","author":"McArthur","year":"2012","journal-title":"Curr. Drug Targets"},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1152\/physiol.00059.2005","article-title":"The Interaction between Pathogens and the Host Coagulation System","volume":"21","author":"Sun","year":"2006","journal-title":"Physiology"},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1038\/nrmicro2648","article-title":"Molecular Insight into Invasive Group A Streptococcal Disease","volume":"9","author":"Cole","year":"2011","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"102420","DOI":"10.1016\/j.mib.2023.102420","article-title":"Group A Streptococcus Interactions with the Host across Time and Space","volume":"77","author":"Guerra","year":"2024","journal-title":"Curr. Opin. Microbiol."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"S160","DOI":"10.1093\/cid\/cix656","article-title":"Infant Group B Streptococcal Disease Incidence and Serotypes Worldwide: Systematic Review and Meta-Analyses","volume":"65","author":"Madrid","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"D7","DOI":"10.1016\/j.vaccine.2013.01.009","article-title":"An Overview of Global GBS Epidemiology","volume":"31","author":"Heath","year":"2013","journal-title":"Vaccine"},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"S152","DOI":"10.1093\/cid\/cix655","article-title":"Risk of Early-Onset Neonatal Group B Streptococcal Disease With Maternal Colonization Worldwide: Systematic Review and Meta-Analyses","volume":"65","author":"Russell","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S0140-6736(11)61651-6","article-title":"Group B Streptococcal Disease in Infants Aged Younger than 3 Months: Systematic Review and Meta-Analysis","volume":"379","author":"Edmond","year":"2012","journal-title":"Lancet"},{"key":"ref_146","unstructured":"(2026, July 20). WHO Preferred Product Characteristics for Group B Streptococcus Vaccines. Available online: https:\/\/www.who.int\/publications\/i\/item\/WHO-IVB-17.09."},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"002115","DOI":"10.1099\/jmm.0.002115","article-title":"Streptococcus Agalactiae Colonization in Pregnant Women: Which Culture-Based Detection Method Is Best?","volume":"75","author":"Schoeler","year":"2026","journal-title":"J. Med. Microbiol."},{"key":"ref_148","doi-asserted-by":"crossref","unstructured":"Liu, Y., and Liu, J. (2022). Group B Streptococcus: Virulence Factors and Pathogenic Mechanism. Microorganisms, 10.","DOI":"10.3390\/microorganisms10122483"},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"21003","DOI":"10.1074\/jbc.M114.553073","article-title":"FbsC, a Novel Fibrinogen-Binding Protein, Promotes Streptococcus Agalactiae-Host Cell Interactions","volume":"289","author":"Buscetta","year":"2014","journal-title":"J. Biol. Chem."},{"key":"ref_150","doi-asserted-by":"crossref","first-page":"3495","DOI":"10.1128\/IAI.72.6.3495-3504.2004","article-title":"The Novel Fibrinogen-Binding Protein FbsB Promotes Streptococcus Agalactiae Invasion into Epithelial Cells","volume":"72","author":"Gutekunst","year":"2004","journal-title":"Infect. Immun."},{"key":"ref_151","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1128\/IAI.67.2.871-878.1999","article-title":"Lmb, a Protein with Similarities to the LraI Adhesin Family, Mediates Attachment of Streptococcus agalactiae to Human Laminin","volume":"67","author":"Spellerberg","year":"1999","journal-title":"Infect. Immun."},{"key":"ref_152","doi-asserted-by":"crossref","unstructured":"Rosini, R., and Margarit, I. (2015). Biofilm Formation by Streptococcus Agalactiae: Influence of Environmental Conditions and Implicated Virulence Factor. Front. Cell. Infect. Microbiol., 5.","DOI":"10.3389\/fcimb.2015.00006"},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1128\/JB.01155-06","article-title":"Group B Streptococcal Capsular Sialic Acids Interact with Siglecs (Immunoglobulin-like Lectins) on Human Leukocytes","volume":"189","author":"Carlin","year":"2007","journal-title":"J. Bacteriol."},{"key":"ref_154","doi-asserted-by":"crossref","first-page":"7465","DOI":"10.1073\/pnas.1815572116","article-title":"Dual Actions of Group B Streptococcus Capsular Sialic Acid Provide Resistance to Platelet-Mediated Antimicrobial Killing","volume":"116","author":"Uchiyama","year":"2019","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_155","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1016\/j.eimc.2017.08.006","article-title":"Serotype, Virulence Profile, Antimicrobial Resistance and Macrolide-Resistance Determinants in Streptococcus Agalactiae Isolates in Pregnant Women and Neonates in Catalonia, Spain","volume":"36","author":"Parra","year":"2018","journal-title":"Enferm. Infecc. Microbiol. Clin."},{"key":"ref_156","doi-asserted-by":"crossref","first-page":"2408","DOI":"10.1128\/IAI.70.5.2408-2413.2002","article-title":"The Group B Streptococcal C5a Peptidase Is Both a Specific Protease and an Invasin","volume":"70","author":"Cheng","year":"2002","journal-title":"Infect. Immun."},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1084\/jem.165.3.720","article-title":"Unspecific Binding of Group B Streptococcal Cocytolysin (CAMP Factor) to Immunoglobulins and Its Possible Role in Pathogenicity","volume":"165","author":"Sterzik","year":"1987","journal-title":"J. Exp. Med."},{"key":"ref_158","doi-asserted-by":"crossref","first-page":"e01058-21","DOI":"10.1128\/Spectrum.01058-21","article-title":"Group B Streptococcus CAMP Factor Does Not Contribute to Interactions with the Vaginal Epithelium and Is Dispensable for Vaginal Colonization in Mice","volume":"9","author":"Ballard","year":"2021","journal-title":"Microbiol. Spectr."},{"key":"ref_159","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1038\/icb.1945.30","article-title":"Further Notes on a Lytic Phenomenon Shown by Group B Streptococci","volume":"23","author":"Christie","year":"1945","journal-title":"Aust. J. Exp. Biol. Med. Sci."},{"key":"ref_160","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.micpath.2007.08.005","article-title":"CAMP Factor Is Not Essential for Systemic Virulence of Group B Streptococcus","volume":"44","author":"Hensler","year":"2008","journal-title":"Microb. Pathog."},{"key":"ref_161","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1016\/j.chom.2015.11.001","article-title":"Group B Streptococcus Evades Host Immunity by Degrading Hyaluronan","volume":"18","author":"Kolar","year":"2015","journal-title":"Cell Host Microbe"},{"key":"ref_162","doi-asserted-by":"crossref","unstructured":"Patras, K.A., and Nizet, V. (2018). Group B SStreptococcal Maternal Colonization and Neonatal Disease: Molecular Mechanisms and Preventative Approaches. Front. Pediatr., 6.","DOI":"10.3389\/fped.2018.00027"},{"key":"ref_163","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1556\/1886.2018.00026","article-title":"Capsular Type, Sequence Type and Microbial Resistance Factors Impact on DNase Activity of Streptococcus Agalactiae Strains from Human and Bovine Origin","volume":"8","author":"Florindo","year":"2018","journal-title":"Eur. J. Microbiol. Immunol."},{"key":"ref_164","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.jinf.2014.06.006","article-title":"Review: Current and New Generation Pneumococcal Vaccines","volume":"69","author":"Feldman","year":"2014","journal-title":"J. Infect."},{"key":"ref_165","unstructured":"Brown, J., Hammerschmidt, S., and Orihuela, C. (2015). Streptococcus Pneumoniae: Molecular Mechanisms of Host-Pathogen Interactions. Streptococcus pneumoniae: Molecular Mechanisms of Host-Pathogen Interactions, Elsevier."},{"key":"ref_166","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1007\/s00109-009-0557-x","article-title":"The Pneumococcus: Why a Commensal Misbehaves","volume":"88","author":"Weiser","year":"2009","journal-title":"J. Mol. Med."},{"key":"ref_167","doi-asserted-by":"crossref","first-page":"3373","DOI":"10.1128\/JCM.39.9.3373-3375.2001","article-title":"Identification of Streptococcus Pneumoniae Revisited","volume":"39","author":"Kellogg","year":"2001","journal-title":"J. Clin. Microbiol."},{"key":"ref_168","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1111\/j.1469-0691.2010.03183.x","article-title":"Streptococcus pneumoniae: Virulence Factors and Variation","volume":"16","author":"Mitchell","year":"2010","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_169","doi-asserted-by":"crossref","first-page":"471","DOI":"10.4049\/jimmunol.173.1.471","article-title":"Dual Roles of PspC, a Surface Protein of Streptococcus pneumoniae, in Binding Human Secretory IgA and Factor H","volume":"173","author":"Dave","year":"2004","journal-title":"J. Immunol."},{"key":"ref_170","first-page":"a010215","article-title":"The Pneumococcus: Epidemiology, Microbiology, and Pathogenesis","volume":"3","author":"Tuomanen","year":"2013","journal-title":"Cold Spring Harb. Perspect. Med."},{"key":"ref_171","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1007\/s12272-017-0933-y","article-title":"Pneumonia and Streptococcus Pneumoniae Vaccine","volume":"40","author":"Kim","year":"2017","journal-title":"Arch. Pharm. Res."},{"key":"ref_172","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s13567-024-01287-w","article-title":"Lipoteichoic Acids Influence Cell Shape and Bacterial Division of Streptococcus Suis Serotype 2, but Play a Limited Role in the Pathogenesis of the Infection","volume":"55","author":"Payen","year":"2024","journal-title":"Vet. Res."},{"key":"ref_173","doi-asserted-by":"crossref","first-page":"5889","DOI":"10.1128\/IAI.68.10.5889-5900.2000","article-title":"Diversity of PspA: Mosaic Genes and Evidence for Past Recombination in Streptococcus pneumoniae","volume":"68","author":"Hollingshead","year":"2000","journal-title":"Infect. Immun."},{"key":"ref_174","doi-asserted-by":"crossref","unstructured":"Li, S., Liang, H., Zhao, S.H., Yang, X.Y., and Guo, Z. (2023). Recent Progress in Pneumococcal Protein Vaccines. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1278346"},{"key":"ref_175","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1128\/MMBR.65.2.187-207.2001","article-title":"Pneumococcal Virulence Factors: Structure and Function","volume":"65","author":"Jedrzejas","year":"2001","journal-title":"Microbiol. Mol. Biol. Rev."},{"key":"ref_176","doi-asserted-by":"crossref","first-page":"2857","DOI":"10.1073\/pnas.0511017103","article-title":"A Pneumococcal Pilus Influences Virulence and Host Inflammatory Responses","volume":"103","author":"Barocchi","year":"2006","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_177","first-page":"321","article-title":"Biological Significance of IgA1 Proteases in Bacterial Colonization and Pathogenesis: Critical Evaluation of Experimental Evidence","volume":"104","author":"Kilian","year":"1996","journal-title":"J. Pathol. Microbiol. Immunol."},{"key":"ref_178","doi-asserted-by":"crossref","first-page":"4215","DOI":"10.1073\/pnas.0637469100","article-title":"Antibody-Enhanced Pneumococcal Adherence Requires IgA1 Protease","volume":"100","author":"Weiser","year":"2003","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_179","doi-asserted-by":"crossref","first-page":"1635","DOI":"10.1128\/IAI.70.3.1635-1639.2002","article-title":"Virulence of Streptococcus Pneumoniae: PsaA Mutants Are Hypersensitive to Oxidative Stress","volume":"70","author":"Tseng","year":"2002","journal-title":"Infect. Immun."},{"key":"ref_180","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1046\/j.1365-2958.1997.5111879.x","article-title":"Competence and Virulence of Streptococcus Pneumoniae: Adc and PsaA Mutants Exhibit a Requirement for Zn and Mn Resulting from Inactivation of Putative ABC Metal Permeases","volume":"25","author":"Dintilhac","year":"1997","journal-title":"Mol. Microbiol."},{"key":"ref_181","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.femsim.2004.07.010","article-title":"PiuA and PiaA, Iron Uptake Lipoproteins of Streptococcus pneumoniae, Elicit Serotype Independent Antibody Responses Following Human Pneumococcal Septicaemia","volume":"43","author":"Whalan","year":"2005","journal-title":"FEMS Immunol. Med. Microbiol."},{"key":"ref_182","doi-asserted-by":"crossref","first-page":"5390","DOI":"10.1016\/j.jmb.2020.08.005","article-title":"The Pneumococcal Iron Uptake Protein A (PiuA) Specifically Recognizes Tetradentate FeIII Bis- and Mono-Catechol Complexes","volume":"432","author":"Zhang","year":"2020","journal-title":"J. Mol. Biol."},{"key":"ref_183","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/S1473-3099(04)00938-7","article-title":"Streptococcus pneumoniae Colonisation: The Key to Pneumococcal Disease","volume":"4","author":"Bogaert","year":"2004","journal-title":"Lancet Infect. Dis."},{"key":"ref_184","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1093\/pch\/8.10.616","article-title":"Community-Acquired Pneumonia in Children","volume":"8","year":"2003","journal-title":"Paediatr. Child Health"},{"key":"ref_185","doi-asserted-by":"crossref","first-page":"2371","DOI":"10.1016\/S0140-6736(25)01493-X","article-title":"Community-Acquired Pneumonia","volume":"406","author":"Reyes","year":"2025","journal-title":"Lancet"},{"key":"ref_186","doi-asserted-by":"crossref","unstructured":"Alves-Barroco, C., Paquete-Ferreira, J., Santos-Silva, T., and Fernandes, A.R. (2020). Singularities of Pyogenic Streptococcal Biofilms\u2014From Formation to Health Implication. Front. Microbiol., 11.","DOI":"10.3389\/fmicb.2020.584947"},{"key":"ref_187","doi-asserted-by":"crossref","first-page":"2983","DOI":"10.1128\/IAI.71.6.2983-2992.2003","article-title":"Extracellular Enzymes with Immunomodulating Activities: Variations on a Theme in Streptococcus Pyogenes","volume":"71","author":"Collin","year":"2003","journal-title":"Infect. Immun."},{"key":"ref_188","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1086\/605085","article-title":"Human Infections Due to Streptococcus dysgalactiae Subspecies equisimilis","volume":"49","author":"Brandt","year":"2009","journal-title":"Clin. Infect. Dis."},{"key":"ref_189","doi-asserted-by":"crossref","unstructured":"Rohde, M., and Chhatwal, G.S. (2012). Adherence and Invasion of Streptococci to Eukaryotic Cells and Their Role in Disease Pathogenesis, Springer.","DOI":"10.1007\/82_2012_281"},{"key":"ref_190","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1159\/000516956","article-title":"The Role of Streptococcal Cell-Envelope Proteases in Bacterial Evasion of the Innate Immune System","volume":"14","author":"McKenna","year":"2021","journal-title":"J. Innate Immun."},{"key":"ref_191","doi-asserted-by":"crossref","first-page":"e02578-24","DOI":"10.1128\/mbio.02578-24","article-title":"Integrative Genomic, Virulence, and Transcriptomic Analysis of Emergent Streptococcus Dysgalactiae Subspecies Equisimilis (SDSE) Emm Type StG62647 Isolates Causing Human Infections","volume":"15","author":"Eraso","year":"2024","journal-title":"mBio"},{"key":"ref_192","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1557\/mrs.2011.71","article-title":"Biofilms as Complex Fluids","volume":"36","author":"Wilking","year":"2011","journal-title":"MRS Bull."},{"key":"ref_193","doi-asserted-by":"crossref","unstructured":"Alves-Barroco, C., Botelho, A.M.N., Am\u00e9rico, M.A., Fracalanzza, S.E.L., de Matos, A.P.A., Guimaraes, M.A., Ferreira-Carvalho, B.T., Figueiredo, A.M.S., and Fernandes, A.R. (2022). Assessing in Vivo and in Vitro Biofilm Development by Streptococcus Dysgalactiae Subsp. Dysgalactiae Using a Murine Model of Catheter-Associated Biofilm and Human Keratinocyte Cell. Front. Cell. Infect. Microbiol., 12.","DOI":"10.3389\/fcimb.2022.874694"},{"key":"ref_194","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1016\/j.ijmm.2015.10.004","article-title":"Assessment and Characterization of Biofilm Formation among Human Isolates of Streptococcus Dysgalactiae Subsp. Equisimilis","volume":"305","author":"Genteluci","year":"2015","journal-title":"Int. J. Med. Microbiol."},{"key":"ref_195","doi-asserted-by":"crossref","first-page":"2470","DOI":"10.1128\/JCM.00008-11","article-title":"Virulence Gene Pool Detected in Bovine Group C Streptococcus Dysgalactiae Subsp. Dysgalactiae Isolates by Use of a Group A S. Pyogenes Virulence Microarray","volume":"49","author":"Rato","year":"2011","journal-title":"J. Clin. Microbiol."},{"key":"ref_196","doi-asserted-by":"crossref","unstructured":"Kireeva, A., and Dmitriev, A. (2023). Identification of Novel Mobile Genetic Elements Associated with Resistance to Macrolide and Lincosamide in Streptococcus dysgalactiae Subsp. equisimilis. Open Microbiol. J., 17.","DOI":"10.2174\/18742858-v17-e230109-2022-16"},{"key":"ref_197","doi-asserted-by":"crossref","first-page":"2286","DOI":"10.1038\/s41467-024-46530-2","article-title":"Inter-Species Gene Flow Drives Ongoing Evolution of Streptococcus Pyogenes and Streptococcus dysgalactiae Subsp. Equisimilis","volume":"15","author":"Xie","year":"2024","journal-title":"Nat. Commun."},{"key":"ref_198","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1016\/j.micinf.2015.11.005","article-title":"Infection of Human Keratinocytes by Streptococcus dysgalactiae Subspecies dysgalactiae Isolated from Milk of the Bovine Udder","volume":"18","author":"Raposo","year":"2016","journal-title":"Microbes Infect."},{"key":"ref_199","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/j.vetmic.2015.07.005","article-title":"Role of Streptococcus uberis Adhesion Molecule in the Pathogenesis of Streptococcus uberis Mastitis","volume":"179","author":"Almeida","year":"2015","journal-title":"Vet. Microbiol."},{"key":"ref_200","doi-asserted-by":"crossref","unstructured":"Pedersen, R.R., Kr\u00f6mker, V., Bjarnsholt, T., Dahl-Pedersen, K., Buhl, R., and J\u00f8rgensen, E. (2021). Biofilm Research in Bovine Mastitis. Front. Vet. Sci., 8.","DOI":"10.3389\/fvets.2021.656810"},{"key":"ref_201","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/j.1574-6968.1999.tb13755.x","article-title":"PauA: A Novel Plasminogen Activator from Streptococcus uberis","volume":"178","author":"Rosey","year":"1999","journal-title":"FEMS Microbiol. Lett."},{"key":"ref_202","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1007\/s40203-023-00181-1","article-title":"In Silico Analysis of Virulence Factors of Streptococcus uberis for a Chimeric Vaccine Design","volume":"12","year":"2024","journal-title":"Silico Pharmacol."},{"key":"ref_203","first-page":"001425","article-title":"In Vitro Determination of Essential Genes Required by Streptococcus uberis to Grow in a Complex Biological Media Relating to Intramammary Infection","volume":"11","author":"Blanchard","year":"2025","journal-title":"Microb. Genom."},{"key":"ref_204","doi-asserted-by":"crossref","first-page":"4842","DOI":"10.1128\/IAI.71.9.4842-4849.2003","article-title":"MtuA, a Lipoprotein Receptor Antigen from Streptococcus uberis, Is Responsible for Acquisition of Manganese during Growth in Milk and Is Essential for Infection of the Lactating Bovine Mammary Gland","volume":"71","author":"Smith","year":"2003","journal-title":"Infect. Immun."},{"key":"ref_205","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1128\/IAI.69.1.392-399.2001","article-title":"Identification and Disruption of Two Discrete Loci Encoding Hyaluronic Acid Capsule Biosynthesis Genes HasA, HasB, and HasC in Streptococcus uberis","volume":"69","author":"Ward","year":"2001","journal-title":"Infect. Immun."},{"key":"ref_206","first-page":"461","article-title":"Virulence Factors of Streptococcus Uberis Isolated from Cows with Mastitis","volume":"45","author":"Oliver","year":"1998","journal-title":"Zentralbl. Veterinarmed. B"},{"key":"ref_207","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.vetmic.2006.02.005","article-title":"Identification, Isolation, and Partial Characterization of a Novel Streptococcus Uberis Adhesion Molecule (SUAM)","volume":"115","author":"Almeida","year":"2006","journal-title":"Vet. Microbiol."},{"key":"ref_208","doi-asserted-by":"crossref","unstructured":"Ward, P.N., Holden, M.T.G., Leigh, J.A., Lennard, N., Bignell, A., Barron, A., Clark, L., Quail, M.A., Woodward, J., and Barrell, B.G. (2009). Evidence for Niche Adaptation in the Genome of the Bovine Pathogen Streptococcus uberis. BMC Genom., 10.","DOI":"10.1186\/1471-2164-10-54"},{"key":"ref_209","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/S0882-4010(03)00150-5","article-title":"Characterization of a Bovine Lactoferrin Binding Protein of Streptococcus uberis","volume":"35","author":"Moshynskyy","year":"2003","journal-title":"Microb. Pathog."},{"key":"ref_210","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1016\/j.tvjl.2005.01.006","article-title":"Biofilms: A Role in Recurrent Mastitis Infections?","volume":"171","author":"Melchior","year":"2006","journal-title":"Vet. J."},{"key":"ref_211","first-page":"305","article-title":"Streptococcus Uberis: In Vitro Biofilm Production in Response to Carbohydrates and Skim Milk","volume":"49","author":"Dieser","year":"2017","journal-title":"Rev. Argent. Microbiol."},{"key":"ref_212","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1016\/j.micpath.2017.03.028","article-title":"Evaluation of Environmental and Nutritional Factors and Sua Gene on in Vitro Biofilm Formation of Streptococcus uberis Isolates","volume":"107","author":"Moliva","year":"2017","journal-title":"Microb. Pathog."},{"key":"ref_213","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1051\/vetres:2004025","article-title":"The Pathogenic Equine Streptococci","volume":"35","author":"Timoney","year":"2004","journal-title":"Vet. Res."},{"key":"ref_214","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1111\/jvim.15043","article-title":"Streptococcus Equi Infections in Horses: Guidelines for Treatment, Control, and Prevention of Strangles\u2014Revised Consensus Statement","volume":"32","author":"Boyle","year":"2018","journal-title":"J. Vet. Intern. Med."},{"key":"ref_215","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.3201\/eid1907.121365","article-title":"Transmission of Streptococcus equi Subspecies zooepidemicus Infection from Horses to Humans","volume":"19","author":"Pelkonen","year":"2013","journal-title":"Emerg. Infect. Dis."},{"key":"ref_216","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1099\/00221287-146-5-1187","article-title":"Localization and Characterization of the Ligand-Binding Domain of the Fibrinogen-Binding Protein (FgBP) of Streptococcus equi subsp. equi","volume":"146","author":"Meehan","year":"2000","journal-title":"Microbiology"},{"key":"ref_217","doi-asserted-by":"crossref","first-page":"3600","DOI":"10.1128\/iai.65.9.3600-3605.1997","article-title":"Comparison of the Sequences and Functions of Streptococcus Equi M-like Proteins SeM and SzPSe","volume":"65","author":"Timoney","year":"1997","journal-title":"Infect. Immun."},{"key":"ref_218","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/j.cveq.2014.08.007","article-title":"New Perspectives for the Diagnosis, Control, Treatment, and Prevention of Strangles in Horses","volume":"30","author":"Waller","year":"2014","journal-title":"Vet. Clin. N. Am. Equine Pract."},{"key":"ref_219","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/S1286-4579(02)01565-4","article-title":"The Molecular Basis of Streptococcus Equi Infection and Disease","volume":"4","author":"Harrington","year":"2002","journal-title":"Microbes Infect."},{"key":"ref_220","doi-asserted-by":"crossref","unstructured":"Holden, M.T.G., Heather, Z., Paillot, R., Steward, K.F., Webb, K., Ainslie, F., Jourdan, T., Bason, N.C., Holroyd, N.E., and Mungall, K. (2009). Genomic Evidence for the Evolution of Streptococcus equi: Host Restriction, Increased Virulence, and Genetic Exchange with Human Pathogens. PLoS Pathog., 5.","DOI":"10.1371\/journal.ppat.1000346"},{"key":"ref_221","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/S0378-1135(99)00051-6","article-title":"In Vivo Pathogenicity and Resistance to Phagocytosis of Streptococcus Equi Strains with Different Levels of Capsule Expression","volume":"67","author":"Anzai","year":"1999","journal-title":"Vet. Microbiol."},{"key":"ref_222","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1294\/jes.25.53","article-title":"The Antiphagocytic Activity of SeM of Streptococcus equi Requires Capsule","volume":"25","author":"Timoney","year":"2014","journal-title":"J. Equine Sci."},{"key":"ref_223","doi-asserted-by":"crossref","first-page":"4817","DOI":"10.1128\/IAI.00751-10","article-title":"Identification of Three Novel Superantigen-Encoding Genes in Streptococcus equi Subsp. zooepidemicus, SzeF, SzeN, and SzeP","volume":"78","author":"Paillot","year":"2010","journal-title":"Infect. Immun."},{"key":"ref_224","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.vetmic.2006.11.023","article-title":"Se18.9, an Anti-Phagocytic Factor H Binding Protein of Streptococcus equi","volume":"121","author":"Tiwari","year":"2007","journal-title":"Vet. Microbiol."},{"key":"ref_225","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.vetmic.2017.01.009","article-title":"Identification of a Novel Host-Specific IgG Protease in Streptococcus phocae Subsp. phocae","volume":"201","author":"Rungelrath","year":"2017","journal-title":"Vet. Microbiol."},{"key":"ref_226","doi-asserted-by":"crossref","first-page":"107726","DOI":"10.1016\/j.micpath.2025.107726","article-title":"Analysis of Distinct Variants of Immunoglobulin G Binding Protein EAG on Humoral Immunity and Bacterial Clearance of Streptococcus equi Subspecies equi","volume":"205","author":"Jiang","year":"2025","journal-title":"Microb. Pathog."},{"key":"ref_227","doi-asserted-by":"crossref","unstructured":"He, L., Khine, N.O., Song, J., Loubi\u00e8re, C., and Butaye, P. (2025). Geographic Diversity of the Streptococcus equi subsp. equi Accessory Genome: Implications for Vaccines and Global Surveillance. Front. Vet. Sci., 12.","DOI":"10.3389\/fvets.2025.1721958"},{"key":"ref_228","doi-asserted-by":"crossref","first-page":"1728","DOI":"10.1128\/IAI.01079-09","article-title":"Contribution of Each of Four Superantigens to Streptococcus Equi-Induced Mitogenicity, Gamma Interferon Synthesis, and Immunity","volume":"78","author":"Paillot","year":"2010","journal-title":"Infect. Immun."},{"key":"ref_229","doi-asserted-by":"crossref","first-page":"4923","DOI":"10.1016\/j.vaccine.2009.06.042","article-title":"Impact of Immunization against SpyCEP during Invasive Disease with Two Streptococcal Species: Streptococcus pyogenes and Streptococcus equi","volume":"27","author":"Turner","year":"2009","journal-title":"Vaccine"},{"key":"ref_230","unstructured":"Proft, T., and Fraser, J.D. (2016). Streptococcal Superantigens: Biological Properties and Potential Role in Disease. Streptococcus pyogenes: Basic Biology to Clinical Manifestations, University of Oklahoma Health Sciences Center."},{"key":"ref_231","first-page":"27","article-title":"A Review of Pneumococcal Vaccines: Current Polysaccharide Vaccine Recommendations and Future Protein Antigens","volume":"21","author":"Daniels","year":"2016","journal-title":"J. Pediatr. Pharmacol. Ther. JPPT"},{"key":"ref_232","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1128\/mBio.00937-20","article-title":"A New Pneumococcal Capsule Type, 10D, Is the 100th Serotype and Has a Large Cps Fragment from an Oral Streptococcus","volume":"11","author":"Ganaie","year":"2020","journal-title":"mBio"},{"key":"ref_233","doi-asserted-by":"crossref","unstructured":"Kong, D., Pan, H., Wu, H., and Chen, J. (2025). Engaging Broader Stakeholders to Accelerate Group A Streptococcus Vaccine Development. Vaccines, 13.","DOI":"10.3390\/vaccines13070734"},{"key":"ref_234","unstructured":"Dale, J.B., Batzloff, M.R., Cleary, P.P., Courtney, H.S., Good, M.F., Grandi, G., Halperin, S., Margarit, I.Y., McNeil, S., and Pandey, M. (2016). Current Approaches to Group A Streptococcal Vaccine Development. Streptococcus pyogenes: Basic Biology to Clinical Manifestations, University of Oklahoma Health Sciences Center."},{"key":"ref_235","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1002\/ijgo.15465","article-title":"Maternal GBS Vaccination for Preventing Group B Streptococcus Disease in Newborns: A Mini Review of Current Evidence","volume":"166","author":"Kokori","year":"2024","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"ref_236","doi-asserted-by":"crossref","first-page":"4877","DOI":"10.1016\/j.vaccine.2019.07.012","article-title":"Vaccines for Maternal Immunization against Group B Streptococcus Disease: WHO Perspectives on Case Ascertainment and Case Definitions","volume":"37","author":"Seale","year":"2019","journal-title":"Vaccine"},{"key":"ref_237","doi-asserted-by":"crossref","first-page":"10381","DOI":"10.3168\/jds.2017-13023","article-title":"A 100-Year Review: Mastitis Detection, Management, and Prevention","volume":"100","author":"Ruegg","year":"2017","journal-title":"J. Dairy Sci."},{"key":"ref_238","doi-asserted-by":"crossref","first-page":"100184","DOI":"10.1016\/j.microb.2024.100184","article-title":"CRISPR-Cas9 System: A Potent Tool to Fight Antibiotic Resistance in Bacteria","volume":"5","author":"Moitra","year":"2024","journal-title":"Microbe"},{"key":"ref_239","doi-asserted-by":"crossref","unstructured":"Wizrah, M.S.I. (2026). CRISPR-Cas Systems as next-Generation Antimicrobials: A Systemic Review of Mechanisms, Delivery Strategies, and Translational Challenges. Front. Microbiol., 17.","DOI":"10.3389\/fmicb.2026.1747931"},{"key":"ref_240","doi-asserted-by":"crossref","unstructured":"Fischetti, V.A. (2018). Development of Phage Lysins as Novel Therapeutics: A Historical Perspective. Viruses, 10.","DOI":"10.3390\/v10060310"},{"key":"ref_241","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1002\/med.21593","article-title":"Phage Therapy: Current Status and Perspectives","volume":"40","author":"Borysowski","year":"2020","journal-title":"Med. Res. Rev."},{"key":"ref_242","doi-asserted-by":"crossref","unstructured":"Oniciuc, E.A., Likotrafiti, E., Alvarez-Molina, A., Prieto, M., Santos, J.A., and Alvarez-Ord\u00f3\u00f1ez, A. (2018). The Present and Future of Whole Genome Sequencing (WGS) and Whole Metagenome Sequencing (WMS) for Surveillance of Antimicrobial Resistant Microorganisms and Antimicrobial Resistance Genes across the Food Chain. Genes, 9.","DOI":"10.3390\/genes9050268"},{"key":"ref_243","doi-asserted-by":"crossref","first-page":"e00140-22","DOI":"10.1128\/cmr.00140-22","article-title":"Integrating Whole-Genome Sequencing into Antimicrobial Resistance Surveillance: Methodologies, Challenges, and Perspectives","volume":"38","author":"Matsumura","year":"2025","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_244","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s12014-026-09592-6","article-title":"Distinct Proteomic Profiles of Clinical Isolates Show Diversity of Pseudomonas Aeruginosa Colistin-Resistance","volume":"23","author":"Sayd","year":"2026","journal-title":"Clin. Proteom."},{"key":"ref_245","doi-asserted-by":"crossref","unstructured":"de Sousa, T., Viala, D., Th\u00e9ron, L., Chambon, C., H\u00e9braud, M., Poeta, P., and Igrejas, G. (2020). Putative Protein Biomarkers of Escherichia Coli Antibiotic Multiresistance Identified by MALDI Mass Spectrometry. Biology, 9.","DOI":"10.3390\/biology9030056"},{"key":"ref_246","doi-asserted-by":"crossref","unstructured":"De Sousa, T., Wang, H.Y., Lin, T.W., Cani\u00e7a, M., Ramos, M.J.N., Santos, D., Silva, C., Saraiva, S., Beyrouthy, R., and Bonnet, R. (2025). Mutational Analysis of Colistin-Resistant Pseudomonas Aeruginosa Isolates: From Genomic Background to Antibiotic Resistance. Pathogens, 14.","DOI":"10.3390\/pathogens14040387"},{"key":"ref_247","doi-asserted-by":"crossref","first-page":"e70004","DOI":"10.1002\/jobm.70004","article-title":"The Interactive Dynamics of Pseudomonas Aeruginosa in Global Ecology","volume":"65","author":"Silva","year":"2025","journal-title":"J. Basic Microbiol."},{"key":"ref_248","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1128\/microbiolspec.ARBA-0009-2017","article-title":"Antimicrobial Resistance: A One Health Perspective","volume":"6","author":"McEwen","year":"2018","journal-title":"Microbiol. Spectr."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/8\/751\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T13:21:12Z","timestamp":1785763272000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/8\/751"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,3]]},"references-count":248,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["antibiotics15080751"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics15080751","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,3]]}}}